I stumbled across an article about another celebrity who has gone through breast cancer treatment. That’s not surprising, given the relatively high percentage of women, in particular, who have been diagnosed or are at heightened risk of the disease.
But this one—about celebrity organizer Clea Shearer (of The Home Edit, a home organizing company/brand/empire)—gave me pause for the specific reason that there was so much cancer-related hardship that continued after she finished her treatment.
In 2022, Clea was diagnosed with stage 2 breast cancer (“invasive mammary carcinoma”) and underwent the familiar treatments of surgery, chemotherapy and radiation therapy. However, it’s the complications of her double mastectomy that make her story very striking. To date (that is, as of the release of this article in People magazine a few days ago), she has undergone 14 surgeries and may be running out of options for breast reconstruction.
And just when you thought you were almost done…
This is not what anyone expects after they “finish” cancer treatment. In fact, Clea was declared cancer-free in November 2022. But it was clearly not the end of cancer-related effects for her.
I think it’s important for us to consider this when we try to be over-optimistic with cancer survivors. Pushing an upbeat attitude or telling survivors to “just be grateful” glosses over the reality of what they may continue to keep going through.
Yes, of course we are grateful. A cancer diagnosis is terrifying and for those of us who grew up when it was considered practically a death sentence, the idea of having it take your life is hard to get out of your head. In this day and age where social media describes the “condition” as d**th…well, cancer survivors have to meet the possibility head-on, minus the asterisks.
However long a survivor has survived is a cause for celebration and gratitude. But it’s not necessarily the end-of-story, fade-into-the-sunset ending. Clea’s experience is proof of that and I wish her strength and perseverance as she navigates the coming months.
Stories like Clea’s underscore the critical need to treat the whole patient, including offering emotional/mental health support, and not to simply stop the support when the cancer center-based treatment ends. Even when it might seem that treatment is done, it may just be the beginning of a new set of challenges.
There is a part of me that would like to stop talking about cancer. Really.
My cancer diagnosis tops my “Worst Things I’ve Gone Through” list, more than any other crappy things that I’ve gone through. Treatment brought me to a screeching halt and forced me to rethink my expectations for what “success” looked like.
It wouldn’t be surprising if I wanted absolutely nothing to do with cancer and chose to never speak of it again.
However, I DID go through this. I WAS angry and frustrated and literally fearing for my life. So I want to own the fact that I faced one of my greatest health fears and was able to come out of the other end of the cancer tunnel.
Undoubtedly, most of my “success” was sheer luck and well-established medical protocols. There are many other cancer patients who go through the same thing but are not so fortunate. Until we know exactly what triggers the development of a tumor and can determine how to effectively avoid that, we will still be riding by the seat of our pants
In that case, isn’t it sort of odd to wear the “cancer survivor” badge like an achievement?
And yet, it does feel like an achievement. Or perhaps, it feels like it gives me a purpose. The entire reason why this blog exists is because I had questions about the experience of being a cancer patient that I could not find answers for, and I wanted to offer what I had gone through in case it might help someone else.
As cancer recurrence became kinda, sorta, maybe less likely with each passing year, I still had an urge to let people know about the disease because it had been so huge in my life. At some point in a conversation, I’d stick in that I was a cancer survivor—it was hard not to, I realized, because there were so many ways that cancer had entangled itself in me.
And people would say congratulations for surviving and then the conversation would become a bit uncomfortable because no one really likes talking about cancer…and everyone would quiet down for a bit. I could easily keep going on about my experiences but I know I’d never get invited to another social event if I did, so I learned to shut up and change the subject.
This blog is my emotional, cancer-indulgent dumping ground.
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If someone mentions that they have a cancer diagnosis, I know what not to say first and foremost, but there’s a balancing act between allowing them the space to express themselves (especially if others around them don’t know what to say) and offering supportive bits of random information about things that actually matter to them.
In online forums, I’ve typed out a block of text…only to delete it before sending. Maybe it’s not as important for me to talk about what I went through as it is to simply be there to listen.
“I see pharmacological interventions in your future” is a paraphrasing of what my oncologist told me at my last doctor’s visit.
So let me back up a bit. I had my “eight-years-since-finishing-chemo” appointment with my oncologist last week. Things went the way they’ve been going for a while. He was very pleased with how things have been going and that made me feel very positive.
Certainly, I have my share of stressors churning at the moment, but most of them are not health-related. Most.
When my oncologist reviewed my bone density reports, however, he made the same prediction that he has during my previous two visits with him (see his quote above). The issue is that my bone scan in 2019 showed osteopenia, which I have to say is pretty weird given my lifestyle, which includes a lot of strength training. We both thought that perhaps it was an issue with the way the numbers were calculated.
Unfortunately, my 2024 bone scan showed a significant loss of bone compared to 2019. Enough to really concern my oncologist and befuddle us both.
So despite my living the lifestyle that medical guidelines say I’m “supposed to” live in order to stay healthy and strong, it’s still not good enough.
This harkens back to what I experienced after being diagnosed with breast cancer. It seemed like I had done everything I could to lessen my chances of getting cancer, including things that should have been protective, but there I was, a breast cancer patient, and a young one at that (which, I later learned, what one of the reasons the risk factors didn’t necessarily apply to me, but I didn’t know that at the time).
It drove my perfectionistic mind haywire.
It brought on feelings of helplessness and even despair.
The only thing that gave me a bit of a lift was learning to meditate. Meditation imparted a sense that I had a teensy bit of control, if not on the situation, at least in the way that I reacted to it.
I got through that period of my life, brushed myself off and went on. And for a while, I was feeling blessed.
But cancer treatments have long-term effects. And the repercussions of being pushed through menopause and being on endocrine therapy eventually caught up to me. Physical movements that used to be easy started to hurt. I lost muscle mass…and apparently, I lost bone too. I felt like I was treading water with a weight tied around me.
Never good enough.
So I am bearing down and reworking my diet and exercise program even more. And to be honest, this is also an opportunity to shed some of my perfectionistic tendencies. While I want to feel like I am doing everything I can to help stop my bone loss and avoid taking medication for it, I need to learn to give myself grace. Sometimes even doing everything “right” will not be 100% successful, and I have to be okay with that.
When I finished my final radiation treatment for breast cancer in 2017, I got to bang a gong as part of my cancer center’s tradition.
The gong-ringing marked getting to a milestone, one that I only dreamed about when I was handed my treatment plan. It felt like closure…except that I wasn’t really “done”—I still had months of Herceptin to go and years of endocrine therapy ahead of me. But the toughest chemo and radiation were over.
And those around me who weren’t done yet also celebrated along, just as I had for the patients that had gone before me, eagerly awaiting their turn at the gong. This tradition also occurs at many other cancer centers, although instead of a gong, it might be a bell or a chime or something similar.
However, as with many things that have to do with cancer, there is a more somber side to the end-of-chemo bell. As noted in this article from Psychology Today (“The Psychology of the Cancer Bell”), hearing the ringing of the bell can be devastating for someone with metastatic cancer, who will never be done with treatment, or is at late stages of the disease.
There are many other creative ways to commemorate the end of treatment for cancer than simply bell-ringing. (Photo by Nick Fewings on Unsplash)
The article also points out that in cases where someone experienced a cancer recurrence, hearing the bell rung by someone else elicited painful emotions. What should be a jubilant event for all can feel depressing and isolating, like being left behind.
But it goes beyond that. As a study by Williams et al. (2019, Int J Radiat Oncol) found, even those who are finishing their treatment might not have a positive response to ringing the bell. From the “Conclusion” section in the study’s abstract:
Not what I would have expected! And it certainly came as a surprise to the study’s authors.
These findings have been reflected in a reimagining of the completion bell. As the Psychology Today article mentions, some cancer centers are moving it’s location and renaming it the “Bell of Hope”, or providing different means of allowing patients to mark the stages of their treatment rather than focusing on “completion”.
Personally, I was looking forward to banging my gong and was more focused on what treats I could bring for the radiology staff and saying goodbye to all of them. But I can see why such a commemoration could be problematic, especially when so many parts of the cancer experience are stressful. You don’t need one more.
How about you? How do you feel about ringing a bell (or similar)? Is there something else that you did or would prefer?
It used to be that people undergoing chemotherapy for cancer were told to be careful with physical activity and restrict themselves to low- and moderate-intensity exercise. Even when I was going through cancer treatment eight years ago, there was concern about how much weight I was lifting for fear of eliciting lymphedema, although by that time, exercise was more encouraged.
I am so glad that our understanding of exercise and cancer has changed! This evolution in thinking is exemplified by a case study that was recently published in the journal Lifestyle Medicine (Rolle & Crane, 2025). The lead author and PhD student in Public Health at U of Miami, LaShae Rolle (age 27), was also a competitive powerlifter who was diagnosed with stage 2B estrogen receptor-positive breast cancer in 2024.
For LaShae, exercise was an integral part of her life, something to which I can relate. She worked with her team to create training sessions that aligned appropriately with her cancer treatments which consisted of four cycles of chemo following a mastectomy.
Remarkably, by modifying her workouts as needed, LaShae was able to maintain 93% of her squat strength (408 lbs of her 441-lb one-repetition maximum (1RM)) and 87% of both her bench press (254 lbs of her 292-lb 1RM) and deadlift (430 lbs of her 497-lb 1RM). This is so impressive considering that throughout her chemo treatment she was still able to squat and deadlift over 400 lbs!
Not surprisingly, attempting to train at high-intensity on the day following her first infusion (!) resulted in severe dizziness and fatigue. By the 3rd and 4th cycles of her chemo, Rolle found that delaying intense exercises for about a week following her infusions allowed her to train more effectively. Note that her chemo cycles were three weeks apart, allowing sufficient time to recover.
Yes, you can train vigorously during chemotherapy!
Why keep training during chemotherapy? There is a rapidly increasing body of research that demonstrates the critical role that physical activity plays in recovery from cancer treatment and avoiding recurrence. Unfortunately, for people who view exercise as a chore or burden, being urged to maintain an exercise program while they’re undergoing something as punishing as chemotherapy may feel like an additional punishment.
But the benefits of exercising throughout treatment, as appropriate, are irrefutable. For those who haven’t previously exercised, it’s important to begin slowly, finding physical activities that are enjoyable and rewarding, eventually ramping up the challenge to include cardiovascular exercise, strength training, balance work and flexibility training.
For those for whom workouts are an integral part of their lives, being encouraged to continue exercising as we have prior to cancer is psychologically uplifting. I’ve written in earlier posts that working out was one of the few things that I could do that gave me a sense of control in the out-of-control landscape of a cancer diagnosis. It helped me feel “normal” when I felt anything but, and that was such an important part of mentally getting through treatment.
Bottom line: Participating in your regular exercise routine during chemotherapy is doable, with modifications, and the physical activity can help you get through the treatment process. While LaShae Rolle did experience treatment side effects, she was able to work around those to limit the amount of strength she lost during chemo to an impressive degree.
REFERENCES
Research Article:
Rolle LD & Crane TE (2025) Exercising Through Breast Cancer: A Case Study on Strength Training During Active Treatment. Lifestyle Medicine, 6, e70034. https://doi.org/10.1002/lim2.70034
Over the last week or so, there have been a number of news articles focused on Catherine, Princess of Wales, who has been talking about life after finishing her cancer treatment.
She is officially in remission from her unspecified cancer, having completed chemotherapy. However, in a conversation on July 2 with hospital patients, staff and volunteers at Colchester Hospital in Essex (in southeast England), the princess noted that there was still more to endure once she was past her cancer treatment.
This is summed up from an article in USA Today (and numerous other outlets):
Wow, this is so relatable! I’m grateful that Kate is discussing life after cancer treatment, especially because she’s a highly public figure.
Many cancer survivors have experiences similar to Kate’s, particularly those, such as breast cancer survivors with hormone-positive cancers, who continue to take “maintenance” medications like tamoxifen and aromatase inhibitors. While many patients expect chemotherapy and radiation to be tough, they are often not prepared for the side effects associated with endocrine treatments that are prescribed to be taken for years after finishing everything else.
Princess Kate breaks with royal protocol in speaking frankly about the struggles following the end of cancer treatment. (Video from TODAY)
But even without endocrine therapy, many cancer survivors are left with long-lasting side effects of varying severity. Some may be truly life-changing. Most of them will prevent a return to “normal” as we used to know it.
That normal, however, is what others may be expecting of you. Or you might expect of yourself. And that’s tough. Kate mentions the importance of reaching out for professional support if it is especially difficult to manage the phase following treatment, and I concur 100%.
Because it’s not simply the side effects…it’s the frustration that we feel with having the side effects linger. Or even the reactions of loved ones who don’t understand why things aren’t back to how they used to be. There is a grieving process associated with the loss of our previous lives that those around us may not appreciate, so I’m glad that Princess Kate is using her position to bring this out into the open.
But I remember “life before cancer” and it felt different. There was a feeling that there was so much life left to live, so many plans still to execute.
I felt bulletproof. My own primary care doctor was impressed that I’d made it through so many years without ever having a major surgery (or any surgery, for that matter). I was looking foward to my future. My workouts were still tough and vigorous and I felt like I was going to age well.
Most importantly, life had a certain magic to it. It felt multidimensional and filled with possibilities, and even with the challenges that I’d had to face, I had hope that things would always get better.
Then I got hit by the locomotive that is cancer and everything ground to a halt. My world went gray and all those plans that I had for “the rest of my life” fell away as all my energy was focused on surviving the diagnosis, surviving chemo…and I didn’t see much past that.
For quite a while after diagnosis, I’d felt like I’d been tossed out by the side of the road. (Photo by Sven Brandsma on Unsplash)
Emotionally, my life felt like a void. I was too afraid to even let hope in because of the fear of having it dashed to pieces.
It was like being out in the wilderness and calling for help but receiving none, not even an echo. Spiritually, it was the loneliest that I’d ever been.
I was no longer on the highway of life. I was sitting in the breakdown lane.
Forgive me if this sounds melodramatic. All my ‘anxiety chickens’ had come home to roost, so to speak. And I wasn’t handling it well.
I dragged myself around treatment like this…although about two weeks before my cancer surgery, I had started mindfulness meditation, encouraged by my radiation oncologist who suggested it as a non-pharmaceutical way of dealing with anxiety.
It was that little ‘peep’ of mindfulness that had I clung to, terrified, in the beginning, not really sure whether or not it was helping. But at least it was something warm at a point when I felt cold and abandoned.
I can honestly say that mindfulness and meditation were what gave me back the strength to persevere through tough times. (Photo by Robin van Holst on Unsplash)
As time went on and I stubbornly refused to miss a day of meditation, that little break in the clouds became bigger. In this case, my obstinance was a blessing. Somewhere in the last almost-eight years, not even sure exactly when, something changed.
The fear and loneliness and bitterness crumbled away. Noticing how things were right now, how beautiful the world was when I chose to appreciate it, helped pull me out of the funk.
In our darkest moment we find our greatest strengths. I wish it weren’t like that, I wish there wasn’t a need to hit lowest lows in order to get the biggest spring back up. But I can say that if my life even before cancer had been easier, I would not have experienced the richness of existence as I do now.
Not everything is okay. In many ways, things are even harder and more frightening. But I can accept that and not feel bitter. My expectations have softened and I pause more often to ground myself, to notice that at this moment, I am safe.
I’ve been writing a lot lately about using yoga to mitigate cancer therapy-related side effects.
In this post, I want to bring your attention to the white paper entitled, “Yoga Interventions for Cancer Patients and Survivors” [Important: this links to the download page on the yoga4cancer website, *not* directly to the pdf itself]. It’s an evidence-based review of research regarding the benefits of a yoga practice in coping with negative side effects that afflict cancer patients and survivors, followed by recommendations for teaching yoga to this population.
The white paper is written in non-technical language, distilling the research down into a form that doesn’t require a scientific background to understand. Additionally, editions are available in Spanish and Japanese, both available on the download page beneath the English version.
If you’d rather not download, you can read the English version below (or click the “download” button underneath the paper for a pdf):
I’ve been coming across a lot of interesting–and hopefully useful– videos. The one I’m posting here is presented by the nonprofit Fund for Sustainable Tomorrows and the American College of Sports Medicine, the latter being the organization through which I received my personal trainer certification almost 16 years ago.
This is a 20-minute film with a hopeful message!
The film, narrated by former Olympic figure skater and cancer survivor Scott Hamilton, showcases the stories of how survivors are using exercise to make themselves feel better and increase their chances for survival. It also shows how our knowledge about physical activity’s benefits during cancer treatment has increased, and the programs that have been created to help cancer patients become and stay active.
It’s amazing to see how within a decade or two the attitude about cancer and exercise has changed. Whereas individuals undergoing cancer treatment used to be told to rest as much as possible, now it’s understood that exercising through your treatment is one of the best ways to not only minimize associated side effects but also decrease the chances of cancer recurrence.
For me, exercising during my treatment was a way to feel normal when everything else felt out of control.
The current recommendation is aerobic activity for 150-300 minutes per week along with twice weekly resistance training sessions. And it’s best to do both types of exercise for a well-rounded program, if you can manage it.
But the most important thing to remember is that no matter what you do, doing something is better that doing nothing. Research has discovered the existence of myokines, hormones that are produced in the tissue of skeletal muscles. They are released during muscular contractions and seem to have anti-cancer properties, slowing cancer growth and spread. That is very exciting news!
Of course, exercise is not a cure, and there is no guarantee that if you are an avid exerciser you won’t get cancer or won’t have it recur. However, there’s a very good chance that physical activity will make you feel better and help you continue with life-saving treatments.
As E. Ronald Hale, MD, MPH, Medical Director of Radiation Oncology at Kettering Health states (from the video), “The best cancer treatment in the world is useless if you can’t get through the cancer treatment.” The side effects from cancer therapies can be debilitating, but getting out and moving will improve your quality of life and help you finish your treatment.
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It’s worth mentioning that the number of exercise professionals who have had additional training in working with cancer patients is growing, which means that cancer-informed trainers and yoga teachers are becoming easier to find. Now it’s the insurance companies that need to get on board.
If you needed yet another reason to turn to meditative exercise practices in the course of cancer treatment, here it is.
A recent, unpublished study that was presented at the 2023 ASCO (American Society of Clinical Oncology) Quality Care Symposium, entitled “Virtual Mind–Body Fitness Classes Show Unexpected Benefit in People with Cancer” (Mao et al., 2023), examined the effects of virtual mind-body fitness classes on visits to urgent care or unplanned hospitalizations for cancer patients who were in active treatment and were dealing with moderate or greater fatigue.
While mind-body practices are already recommended for cancer patients to help deal with the symptoms of treatment and its emotional fallout, the results of this study illuminated specific benefits. Those patients who had been assigned to the group given access to virtual live mind-body and fitness classes (called Intergrative Medicine at Home, or IM@Home) had fewer hospitalizations and shorter hospital stays, in addition to fewer visits to urgent care, compared to those subjects who were only given access to pre-recorded online meditation resources (Enhanced Usual Care, or EUC).
It’s not surprising that mindfulness benefits cancer patients, although it’s striking how those benefits manifest themselves.
This study was run at the renown Memorial Sloan Kettering Cancer Center (MSKCC) with 200 cancer patients randomized into the two groups (IM@Home and the stan, which makes the design more solid and increases confidence in the results. Nonetheless, as the lead author Dr. Jun Mao (Chief of Integrative Medicine at MSKCC) stated in the National Cancer Institute’s Cancer Currents blog, “I do want to caution that the current trial was designed as an early-phase trial, so we would like to do a larger study with longer follow-up to confirm our results before we are completely confident in the findings.”
A larger study is currently in the works. Dr. Mao would like to explore whether these classes help patients follow through on their treatment plans, and if so, whether these patients also live longer.
The IM@Home group’s classes included a variety of classes (again, quoted from Cancer Currents blog): “Some of the classes taught participants movement-based activities such as yoga, tai chi, and dance therapy; other classes taught meditation-based practices, such as music therapy and mindfulness.” It is already known that exercise during cancer treatment can reduce fatigue, but the researchers felt that part of the success of this study was due to the participants’ ability to choose the level of exertion based on how they were feeling at the time of the class.
Looking forward to further research on the ways that we can support cancer patients physically, emotionally and spiritually!
As Dr. Mao pointed out, more directed research on this must be done before drawing specific conclusion, but this was a very valuable pilot program, the results of which would not surprise those of us who have made use of various exercise modalities, particularly those with a mind-body angle, for calming ourselves during our cancer journeys.
The more this subject is studied, the greater the chance that cancer centers focusing on whole-patient treatment will be offering such classes to their patients. COVID taught us that there are ways to make classes accessible to people with limited mobility or conditions that may prevent physical travel to classes.
While I believe that attending mind-body oriented classes in person is ideal, this study illustrated that even virtual opportunities can have significant benefits for the patient.
It’s worth pointing out that of the 200 study participants, 91% were female and 77% were white. That is not a diverse spread and reflects the typical clientele at your average yoga studio (based mainly on my personal observations), with the exception being that the average age of these study participants was 60 years. I would be willing to bet that less-represented groups would benefit greatly from the stress relievers offered here and I hope that the researchers expand their subject pool to balance out the participants in their future study.
Regardless, these are intriguing results that underscore the important of mind-body focused classes, and exercise in general, in the well-being and improvement of cancer patients. This study joins a growing list of research that is changing the way that we look at managing cancer treatment side effects.
Research Study Abstract Mao, JJ et al., Effect of virtual mind-body fitness program on reduction in unplanned hospitalizations among patients undergoing active cancer treatments: A pragmatic randomized clinical trial, presented at 2023 ASCO Quality Care Symposium, October 28, 2023: https://meetings.asco.org/2023-asco-quality-care-symposium/15514?presentation=227485#227485 (note: click on “Abstract 473” on right side panel for abstract text)
Frantic Shanti 